Provider Demographics
NPI:1033102520
Name:HORCHOS, PAUL W (DO)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:W
Last Name:HORCHOS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5 MORGAN HWY
Mailing Address - Street 2:SUITE 4
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18508-2641
Mailing Address - Country:US
Mailing Address - Phone:570-344-3788
Mailing Address - Fax:570-969-9280
Practice Address - Street 1:5 MORGAN HWY
Practice Address - Street 2:SUITE 4
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18508-2641
Practice Address - Country:US
Practice Address - Phone:570-344-3788
Practice Address - Fax:570-969-9280
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS009683L208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001654303-0002Medicaid
PA902508OtherBLUE CARE
PA21992-1067OtherGEISINGER
PAP00121395OtherRAILROAD MEDICARE
PA2159434OtherAETNA
PA20012325OtherAMERIHEALTH
PA50075034OtherCAPITAL BLUE CROSS
PA804445OtherBLUE CARE HMO (FPH)
PA001654303-0002Medicaid
PA21992-1067OtherGEISINGER